Application Form for Global Leaderprogram for Social Design and Management
University of Tokyo
Application Form for Global LeaderProgram for Social Design and Management
Spring 2017
<NOTICE>
-This application form must be filled either in Japanese or English.
-The first page should be written in Japanese if an applicant is able to write Japanese.
-Please fill the other side as well.
Applicant information
(Phonetic spelling)Name (in Kanji if applicable) / Male
Female
Nationality
Date of birth
Residential address / Postcode:
Address:
Cell phone or day time phone number:
Affiliation / Graduate School of
Department of
Phone number:
M1 M2 D1 Student ID number:
Supervisor / Name: E-mail:
Faculty
Doctoral program to enter / Graduate School of
Department of
Employer (if you currently have a job.)
Other work experiences / * List the jobs you made your living by with the period of employment, Part-time jobs and internships should be excluded.
Research subject
Educational background / Graduated from Faculty of(FACULTY NAME) of (UNIVERSITY NAME) in( MONTH YEAR)
Admitted to (PROGRAM NAME) Master’s Program of University of Tokyo Graduate School of (SCHOOL NAME) in ( MONTH YEAR)
Admitted to Doctoral Program in ( MONTH YEAR)
Special achievement
Do you receive any scholarship? ( Yes / No )
If yes, →Specify the name of the scholarship:
Period: Monthly amount in yen:
Do you wish to receive GSDM grant? ( Yes / No )
* Note that the recipients of the GSDM grant are not allowed to receive other financial aids or part-time job earnings.
Are you currently enrolled in any leading program? ( Yes / No )
→If yes, specify the name of the program. ( )
Are you applying for another leading program? ( Yes / No )
→If yes, specify the name of the program. ( )
2. Research plans(You may include charts. The minimum point size of text should be 10 points. You are not permitted to modifyor add to the form (here or hereinafter)
You must include the followings:
(1) Describe your research background and issues to date with reference materials
(2) Describe your research objectives, methodologies, and contents
(3) Describe the features, key focuses, and innovative aspects of your research, as well as the impact of your research when completed
(4) Specify your research plan and clarify the scope of your research in detail
Applicant name:
3.Relevance of your research in relation to practical issues in public policy or other areas
Describe how your research can contribute to the clarification of practical issues and/or to the drafting of public policy measures, as well as to the solution of social problems. Your statement should include possible hurdles (legally, ethically etc.) you may face when your research is utilised in and applied to social domains.
.
Applicant name:
4. What motivated you to participate in this program and your career plans
Explain why you apply for this leading program and outline your post-doctoral career plans, including business categories such as industry, academia, or government service (describe from science & technology and public policy perspectives how you would, through your career, aim to resolve issues facing thesociety, the international community, and industry). Also mention your strength and other information you consider particularly important, such as notable research presentations, academicdistinctions, awards, experience of studying abroad, or noteworthy off-campus activities.
Applicant name:
5. Progress of your research
(1)Overview of your research activities to date.
Research activities could encompass graduate research and other equivalent researches such asSpecial Projects and Special Laboratory Work（特別実験、特別演習）.
You should recordthe following items only where you played central roles. Number the items sequentially and record “None” where an item is not relevant. Underline your name.
(2)Presentations at domestic academic societies,symposiums or international conferences
(Distinguish whether the presentations were verbal or by poster as well as whether they were peer reviewed or not)
Record items only whenyou were the presenter. Write author names (list the names of all the members involved, including yourself in the same order as at the time of presentation; if there are too many authors, however,you may partially omit names by stating how many other authors there were), titles, names of academic societies at which presentations were made, numbers on the papers, locations, and dates.Exclude scheduled presentations.However, you can includethe items which have already been accepted for presentation. In that case, documentary proofmust be attached.
(3)Papers published in academic journals, books and others
(Limited to the works that have already printed or accepted. Please categorize according to whether or not the work has been peer-reviewed)
Record in the following order:author names (List the names of all the members involved, including yourself in the same order as appeared in the papers. If there are too many authors, you may partially omit names by stating how many other authors there were), titles, publication names, publishing office, issue numbers, pages, and years. Append proof for the acceptedworks that have not been published.
(4)Others
(Awards, etc.)
Applicant name:
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Letter of Opinion
リーディング大学院申請者に関する意見書
This"Letter of Opinion" must be completed by your supervisor. Please enclose the letter in a 240 x 332mm envelope for A4 sizedocuments and write the applicant’s name and major on the front.
このページは指導教員が作成し，A4書類用（角形2号）封筒に入れて封をしてください（表に応募者の名前と所属専攻を明記）。
1. Applicant name2. Research subject (write“Research subject” on the Application Form)
3. Assessment of applicant
1. Overall assessment
Please circle the relevant itemsfor your overall assessment of the applicant’s research capabilities and rank your recommendation. / (1) Among the graduate students I have supervised, the applicant ranks:
a. Top 10%b. Top 25%c. Top 50%
d. Lower than the top 50%
(2) I rank this applicant as no. out of applicants I recommend
This letter is written by:
Full name: (Seal/Signature)
Graduate School of /Institute of , the University of Tokyo
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